Posted on May 24, 2017

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Many of America's physicians are coming to grips with the implications of the payment reforms inherent in the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).   But only now are others in the health care sector — health systems, health plans, life sciences companies, and others — understanding the implications for themselves.  The most forward-thinking now recognize that both opportunities and challenges await as they reconfigure themselves around a medical payment system more closely tied to value than ever.

Download Report: “Rebuilding the foundation of health care under MACRA”

The Network for Excellence in Health Innovation (NEHI) and the Deloitte Center for Health Solutions convened 31 senior leaders, including many of the top stakeholders in the health care industry, to discuss how they will approach the changes.  The subsequent report describes the steps many are contemplating to prepare for the transition that will be propelled forward by MACRA. 

“MACRA's Quality Payment Program for physicians should be understood as a quantum leap in the transition from fee-for-service to health care compensated on the basis of quality and cost," says Susan Dentzer, CEO of Network for Excellence in Health Innovation (NEHI). “Remember the old cliché that the most expensive instrument in health care is the doctor's pen?  Now the doctor has a new set of motivations in writing her orders — and the rest of the health care sector has to be prepared for the transformative effects." 

The report states: Most US health care organizations have built their foundation on the financial incentives in fee-for-service (FFS) payment models. Changing their systems and processes to respond to MACRA’s very different incentives will take time and is likely to pose challenges for many health care stakeholders. But findings from our cross-industry convening suggest that many health care organizations are ready to come together around new clinical delivery and payment models… laying new financial and operational groundwork that could transform the system for years to come.” 

 Convening executives agree that, under MACRA: 

  • Investments in technology and data will be critical. Systems with strong capabilities in health information technology will be able to attract physicians who need those supports to participate in advanced alternative payment models under MACRA. 
  • Physician groups will need partners to help them take on greater risk. Participation in alternative payment models requires doctors to take on more than nominal amounts of risk, and many are unprepared for the consequences. 
  • New collaborations will not only be possible, but necessary. Life sciences companies, for example, may be able to provide physicians with “real world evidence” on use of their products to help inform treatment decisions and document long-term costs and outcomes.

Network for Excellence in Health Innovation (NEHI) is a nonprofit, non-partisan think tank and membership organization focused on innovations that lead to better health care, smarter spending, and healthier people.  See more at



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